"The next mouthful will be the best": influence of prevision of the pleasure on the decision of having a second helping of a just eaten food.

PURPOSE: Firstly, to see if the decision to have a second helping of food is related to the current evaluation of its palatability or to the predicted pleasure of a second helping of the same food. Secondly, to see if there is any relationship between subjects' BMI, their current or predicted evaluation of food palatability and their decision to have a second helping. METHODS: 128 guests attended a village festival with the specific purpose of eating a traditional, local soup made of beans and bacon. Subjects were asked to indicate the pleasure they felt eating the soup and the pleasure they predicted they would feel by having a second helping of the same food. Subjects were then offered a second identical portion of the above described soup. RESULTS: 72 subjects accepted a second helping of the soup. We discovered a significant correlation between predicted pleasure and the decision to have a second helping of the same food. There was also a significant correlation between BMI and the level of predicted pleasure of a second helping. CONCLUSIONS: The decision to have a second helping of food was related to predicted pleasure and not to the pleasure that was experienced during the first helping.

The DSM-5 effect: psychological characteristics of new patients affected by Binge Eating Disorder following the criteria of the DSM-5 in a sample of severe obese patients.

PURPOSE: The current study evaluated whether or not there were significant differences in psychopathological traits between three groups of individuals. The first was a group of patients seeking bariatric surgery diagnosed as being affected by Binge Eating Disorder (BED), according to the new criteria of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. This group (NEW BED group) did not meet BED diagnosis following the previous criteria listed in the DSM-IV-TR. The second group of individuals was composed of severely obese patients seeking bariatric surgery not affected by an eating disorder, according to the diagnostic criteria of the DSM-5 (OB group). The third group was composed of individuals within a healthy weight range (Control group). METHODS: 94 severely obese patients (33 in the NEW BED group and 61 in the OB group) were compared to the Control group including 41 participants on depression, anxiety and eating habits. RESULTS: The NEW BED scored significantly higher than the OB group on the Beck Depression Inventory, both the subscales of the State Trait Anxiety Inventory, on disinhibition and hunger subscales of the Three-Factor Eating Questionnaire and on many subscales of the Eating Disorders Inventory. CONCLUSIONS: The new, less restrictive diagnostic criteria for BED of the DSM-5 are useful in identifying obese patients affected by severe psychopathology and dysfunctional eating habits.

Alexithymia is not related to severity of night eating behavior: a useful distinction from other eating disorders.

OBJECTIVE: Patients affected by Night Eating Syndrome (NES) complain of insomnia, mood, anxiety and overeating, which have all been linked to difficulties in dealing with emotions, but no research has examined the levels of alexithymia among NES patients. We compared the levels of alexithymia among samples of: NES patients, insomniac patients who do not eat at night, and a control group. METHOD: The study included 153 participants: 34 with NES, 47 with insomnia, and 72 in the control group. Half of the NES group was recruited in a weight and eating disorders center in Philadelphia and the other in a sleep disorders center in Bologna, Italy. Alexithymia was evaluated through the Toronto Alexithymia Scale (TAS). RESULTS: All groups scored in the normal range of the TAS. There was no relationship between alexithymia and the severity of NES. The insomnia participants reported the highest levels of alexithymia and NES patients the lowest. All NES patients' scores were under the clinical cut-off for alexithymia. DISCUSSION: These data differ from the high levels of alexithymia reported by the literature among patients affected by Binge Eating Disorder (BED), suggesting that abnormal diurnal and nocturnal eating patterns, even though they may share several symptoms, are distinct syndromes having different psychopathological pathways.

Psychopathological characteristics of patients seeking for bariatric surgery, either affected or not by binge eating disorder following the criteria of the DSM IV TR and of the DSM 5.

UNLABELLED: We evaluate whether there are any significant differences in psychopathology between severe obese patients affected by Binge Eating Disorder diagnosed following both the DSM IV TR and the DSM5 criteria, and severe obese patients not having an eating disorder. METHOD: 118 severe obese patients seeking treatment at a center for bariatric surgery in northern Italy were asked to take part in the current study for a period of six months. Average participant age was 44.27 years, SD 12.42. Age ranged from 18 to 67 years. Average patient BMI was 45.03, SD 7.11, ranging from 32.14 to 66.16 kg/m(2). Seventy seven of the patients (65.3%) were females and 41 (34.7%) were males. BED diagnosis was determined following the diagnostic criteria of both the DSM IV TR and the DSM 5. The presence of other eating disorders was excluded through a clinical screening using the Eating Disorder Inventory (EDI). Patient eating habits and the presence of emotional eating were appraised using the Three-Factor Eating Questionnaire. Levels of depression and anxiety were evaluated using the Beck Depression Inventory and the State Trait Anxiety Inventory. RESULTS: 57 out of 118 patients were found to be affected by BED following the DSM 5 criteria; among them 24 followed those of the DSM IV TR. BED patients scored higher on four subscales of the Eating Disorders Inventory: Drive for thinness (DT), Bulimia (B), Body dissatisfaction (BD) and Interoceptive awareness (IA) on the STAI and on the Disinhibition and Hunger subscales of the TFEQ. DISCUSSION: The results confirm the presence of high levels of psychopathology among patients diagnosed with BED, even if they have been diagnosed following the criteria of the DSM 5. There is a great overlap in psychopathology between BED patients diagnosed following the DSM IV TR and the DSM 5 criteria.

Clinical validity of the descriptor. "presence of a belief that one must eat in order to get to sleep" in diagnosing the Night Eating Syndrome.

The diagnostic criteria for the Night Eating Syndrome (NES) published in 2010 require the presence of two core criteria: evening hyperphagia and/or nocturnal awakenings for ingestion of food and three of five diagnostic descriptors. One of the descriptors is as follows: "The belief that one must eat in order to fall asleep". In this study we evaluated whether this conviction is significantly more prominent in obese individuals suffering from insomnia and nocturnal eating, than among obese patients with insomnia who do not eat at night. Ninety-eight obese subjects afflicted by insomnia were included in this study. Eight were affected by NES, 33 by Binge Eating Disorder (BED), and 13 by both BED and NES. Subjects' insomnia and sleep disturbances were assessed using the Insomnia Severity Index and the Sleep Disturbance Questionnaire. The presence of the belief that one must eat at night in order to sleep was evaluated with the question: "Do you need to eat in order to get back to sleep when you wake up at night?" Patients affected by NES and by both BED and NES were convinced that nocturnal food intake was necessary in order to fall back asleep after a night time awakening. The presence of this belief seemed to be a critical factor in identifying the presence of the Night Eating Syndrome among obese subjects suffering from insomnia.

Defining the borders between Sleep-Related Eating Disorder and Night Eating Syndrome.

OBJECTIVES: Nocturnal eating is a common symptom of two clinical conditions with different pathogenesis and needing different therapeutic approaches: Sleep Related Eating Disorder (SRED) and Night Eating Syndrome (NES). The first is considered a parasomnia while the second is an eating disorder; however, the distinction between SRED and NES is still a controversial matter. The aim of this study was to better define psychological, behavioral, and polysomnographic characteristics of the two syndromes. METHODS: An eating disorders' specialist tested a group of 28 nocturnal eaters diagnosed as affected by SRED by a sleep expert, following the current criteria of the international classification of sleep disorders, to find out if any of them was affected by NES according to the criteria suggested by both sleep and eating disorders specialists during the first international meeting on Night Eating Syndrome (Minneapolis, 2009) and if they had specific psychological or polysomnographic characteristics. RESULTS: Twenty-two subjects were diagnosed to be affected by NES. They scored higher on the physical tension subscale of the Sleep Disturbance Questionnaire (SDQ) and on the mood and sleep subscale of the Night Eating Questionnaire (NEQ), but there were no other significant differences between SRED and NES patients nor for age, Body Mass Index (BMI), or gender distribution. CONCLUSIONS: The overlap between the symptomatology and the polysomnographic characteristics of the two pathologies and the difficulty in making a differential diagnosis between NES and SRED indicate the need for an update of the diagnostic criteria for SRED, as was recently done for NES.

Daily and nightly anxiety among patients affected by night eating syndrome and binge eating disorder.

We tested if there were any differences about nocturnal and diurnal anxiety between patients either affected by Binge Eating Disorder (BED) or Night eating Syndrome (NES). Fifty four patients affected by BED, 13 by NES and 16 by both BED and NES were tested using the Self Rating Anxiety Scale (SAS) and the Sleep Disturbance Questionnaire (SDQ). Their nocturnal eating behavior was ascertained through the Night Eating Questionnaire (NEQ). Patients affected by both BED and NES scored significantly higher on SAS than other patients. Among NES patients we found a correlation between a SDQ subscale and two subscales of the NEQ. Among BED patients we found a correlation between SAS scores and the nocturnal ingestion subscale of the NEQ. Nocturnal eating is related to nocturnal anxiety among NES patients while it is related to diurnal anxiety among patients affected by BED. These findings support the hypothesis that BED and NES are distinct syndromes sharing overeating but with different pathways to excessive food intake.

Food is never enough: nature and nurture's influence on children's food dose evaluation.

This study investigated whether if socioeconomic factors and\or food palatability influence food amount evaluation among children. Ninety-four children, 10-15 years old, living in Mali in Africa, and 124 living in northern Italy were asked to evaluate an amount of palatable and non palatable candies. The evaluations were compared both to the real number of candies and to that given by the other group. Both Italian and Malian children underestimated the edible candies, interestingly however Malian children did not underestimate altered candies. The data suggest that food dose underestimation is a transcultural characteristic. Evaluation of palatable food is not influenced by socio cultural factors. Underestimation could be a biological protective factor against food shortage; in case of food abundance it could play a role in onset and maintenance of obesity.

Visual evaluation of food amount in patients affected by Anorexia Nervosa.

OBJECTIVE: The study compares visual evaluation of an amount of food and an amount of nonedible objects in patients affected by Anorexia Nervosa and control subjects. METHOD: 59 anorexic subjects were asked to evaluate an amount of candies and plastic bricks shown to them. Their answers were compared to both the real number of objects and the parallel evaluations given by 56 control subjects. RESULTS: There were no significant differences in stimuli evaluation between patients affected by AN and control subjects. Both groups reported a significantly lower number of both candies and bricks in comparison to their real number. DISCUSSION: In an experimental condition not related with food intake there is the same under-evaluation of the amount of presented food and nonedible objects among patients affected by AN and Control Subjects. The clinical finding of overestimation of food intake among patients affected by AN seems not to be due to a perceptive bias.